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자료유형
학술저널
저자정보
Se Hun Chang (Department of Neurosurgery Kyung Hee University Hospital at Gangdong) 신희섭 (Department of Neurosurgery Kyung Hee University Hospital at Gangdong) 이승환 (경희대학교) Hak Cheol Koh (Department of Neurosurgery Kyung Hee University Hospital at Gangdong) 고준석 (Department of Neurosurgery Kyung Hee University Hospital at Gangdong)
저널정보
대한뇌혈관외과학회 Journal of Cerebrovascular and Endovascular Neurosurgery Journal of Cerebrovascular and Endovascular Neurosurgery Vol.17 No.3
발행연도
2015.1
수록면
209 - 216 (8page)

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Objective: Early rebleeding after coil embolization of ruptured intracranial aneurysms is rare, however serious and fatal results of rebleeding have been reported. We studied the incidence and angiographic and clinical characteristics of rebleeding of ruptured aneurysms occurring in the immediate postoperative period after coil embolization. Materials and Methods: We analyzed patients who had aneurysmal subarachnoid hemorrhage and underwent coil embolization. Patients with dissecting aneurysms, blood blister-like aneurysms, fusiform aneurysms, and pseudoaneurysms were excluded. This study included 330 consecutive patients. The clinical and radiological data of 7 of these patients with acute rebleeding after coil embolization were reviewed. Results: The incidence of rebleeding of ruptured aneurysms after coil embolization was 2.1% (7/330), and all cases of rebleeding occurred in the immediate postoperative period within 3 days after coiling. The radiological characteristics were as follows: anterior communicating artery (ACoA) aneurysm (71.4%, 5/7); presence of intracerebral hemorrhage (ICH, 71.4%, 5/7); dome-to-neck ratio < 2 (42.9%, 3/7); presence of bleb (42.9%, 3/7); and subtotal occlusion of aneurysm after coiling (14.3%, 1/7). A thrombolytic agent was administered in 1 patient and continued anticoagulation was performed in 2 patients. Rebleeding patients showed a very poor outcome (Glasgow Outcome Scale 1, 85.7%, 6/7). Conclusion: The prognosis of early rebleeding was very poor. Location of aneurysms on ACoA, the unilateral hypoplasia of A1 segment, presence of ICH and bleb, and adverse events during the procedure were probably associated with early rebleeding of ruptured intracranial aneurysms in the immediate postoperative period after coil embolization.

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참고문헌 (18)

참고문헌 신청
Asgari S / 2003 / Recurrent hemorrhage after initially complete occlusion of intracranial aneurysms / Neurosurg Rev 26(4):269~274 google schola Bavinzski G / 1999 / Treatment of basilar artery bifurcation aneurysms by using Guglielmi detachable coils: a 6-year experience / J Neurosurg 90(5):843~852 google schola Chen H / 2014 / A1 segment hypoplasia accompanied by AcomA aneurysms assessed with magnetic resonance angiography / Surg Radiol Anat 36(4):353~357 google schola Cho YD / 2012 / Early recurrent hemorrhage after coil embolization in ruptured intracranial aneurysms / Neuroradiology 54(7):719~726 google schola Hayashi K / 2007 / Ruptured cerebral aneurysm complicated with rebleeding following thrombolysis during endovascular embolization: two case reports / Neurol Med Chir 47(6):261~264 google schola

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